EP0570675B1 - Pince pour la préhension et le maintien de tissus - Google Patents

Pince pour la préhension et le maintien de tissus Download PDF

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Publication number
EP0570675B1
EP0570675B1 EP93104077A EP93104077A EP0570675B1 EP 0570675 B1 EP0570675 B1 EP 0570675B1 EP 93104077 A EP93104077 A EP 93104077A EP 93104077 A EP93104077 A EP 93104077A EP 0570675 B1 EP0570675 B1 EP 0570675B1
Authority
EP
European Patent Office
Prior art keywords
rod
closing force
forceps according
rod part
actuating rod
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP93104077A
Other languages
German (de)
English (en)
Other versions
EP0570675A1 (fr
Inventor
Manfred Boebel
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Richard Wolf GmbH
Original Assignee
Richard Wolf GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Richard Wolf GmbH filed Critical Richard Wolf GmbH
Publication of EP0570675A1 publication Critical patent/EP0570675A1/fr
Application granted granted Critical
Publication of EP0570675B1 publication Critical patent/EP0570675B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25B—TOOLS OR BENCH DEVICES NOT OTHERWISE PROVIDED FOR, FOR FASTENING, CONNECTING, DISENGAGING OR HOLDING
    • B25B7/00—Pliers; Other hand-held gripping tools with jaws on pivoted limbs; Details applicable generally to pivoted-limb hand tools
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25B—TOOLS OR BENCH DEVICES NOT OTHERWISE PROVIDED FOR, FOR FASTENING, CONNECTING, DISENGAGING OR HOLDING
    • B25B7/00—Pliers; Other hand-held gripping tools with jaws on pivoted limbs; Details applicable generally to pivoted-limb hand tools
    • B25B7/12—Pliers; Other hand-held gripping tools with jaws on pivoted limbs; Details applicable generally to pivoted-limb hand tools involving special transmission means between the handles and the jaws, e.g. toggle levers, gears
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles

Definitions

  • the invention is based on a pair of pliers with two jaw parts for gripping and holding tissue or the like, in which at least one jaw part can be pivoted relative to the other by adjusting an actuating rod by means of a handle, and the closed position of the jaw parts and the handle can be fixed by a lock.
  • Tissue clamps or clamps for stopping and ligating vascular-supplied organs or tissue regions are already known, which ensure secure fixation of the detected tissue by means of a specially developed locking mechanism (DE 39 31 577 A). With this type of locking mechanism, the mechanics of such pliers or clamps reliably snap into place after overcoming a pressure point and fix them securely. The fixation is released via a further pressure point.
  • the object of the invention is to design a generic pliers so that the closing force acting on the tissue section or the like located between the two pliers jaw parts can be changed and fixed in order to prevent traumatization of tissue if necessary.
  • the pliers should meet all of the requirements mentioned above, in particular with regard to an absolutely safe function.
  • the closing force of the pliers jaw parts can be set to different values, wherein the force exerted on the actuating rod via the handle is transferred directly to the movable jaw part when the maximum closing force is set and indirectly when at least one other lower closing force is set.
  • the pliers can be fixed by a lock, and on the other hand, different closing forces are additionally defined in stages so that the tissue is not traumatized.
  • both the maximum closing force - for grasping tissue for example, where it is irrelevant whether it is traumatized or not - can be set, as well as other smaller closing forces - for grasping tissue, which must under no circumstances be traumatized - and depending on the sensitivity of the tissue to be grasped.
  • the operating rod of the forceps consists of a distal first rod part and a second rod part running proximally therefrom, the first being directly connected to the movable jaw part.
  • the second rod part can be rotated relative to the first and is equipped with drivers which are arranged at an axial distance from one another and at angles to one another and which cooperate with coulisse, so that at a predetermined rotational position of the second rod part which specifies the closing force, only the the driver required for this closing force engages with the backdrop assigned to it.
  • the defined actuating force can thus be transmitted directly or indirectly via compression springs from the second to the first rod part, which depends on which of the drivers is brought into engagement with the link arranged on it.
  • Recesses are provided in the scenes, which ensure free axial passage of drivers that are not in the switching position.
  • the compression springs bring the link parts against the intended stops or ring shoulders.
  • Such ring grooves secure idle scenes against movement in the proximal direction.
  • the actuating rod on the proximal side has a switching ring which is equipped with a spring which can be rotated relative to a fixed part, and this has an inwardly directed lug which, depending on the switching position, engages in one of several recesses in the fixed part mentioned and thus the rotational positions of the second rod part fixed in order to be able to set different closing forces in a targeted manner.
  • the rotatable spring can be equipped in such a way that it is interrupted by a pin and fixed on the switching ring. This measure prevents adjustment or twisting of the split spring within an annular groove located between the switching ring and the spring. As a result, the switching ring and consequently also the proximal rod part can only be fixed in a defined position.
  • the tissue forceps according to the invention have two jaw parts 1 and 2 for grasping and holding the tissue at the distal end, an actuating rod 3 connected to them and a handle 4 with an integrated locking mechanism or locking means 5 at the proximal end, which are used for fixing the closed position of the jaw parts 1 and 2 cares.
  • One jaw part 1 can be pivoted relative to the other 2 by axially adjusting the actuating rod 3 by means of the handle 4.
  • the closing force that can be transmitted to the two jaw parts 1 and 2 with the actuating rod 3 can be adjustable, for example, in three defined stages.
  • Figure 3 shows such an embodiment with corresponding components. Here the device for switching the closing force is shown.
  • the actuating rod 3 consists of a distal first rod part 8 and a second rod part 9 which extends proximally therefrom and a third rod part 10.
  • the distal part 8 is connected directly to the swiveling jaw part 1, for example via a joint.
  • the proximally extending second rod part 9 is designed so that it is rotatable relative to the first 8.
  • the second rod part 9 is equipped with carriers 11, 12 and 13 which are arranged at an axial distance from one another and at an angle to one another and which cooperate with axially movable links 14, 15, 16, 17, 18, 19 and 20.
  • the maximum closing force is to be transmitted, then in the rotational position of the second rod part 9 according to FIG. 3, only the driver 11 engages with the first link 14, 15 and 16 which is fixedly connected to the first rod part 8. If the closing force is reduced in stages, the driver 12 and then the driver 13 are in engagement with the respectively associated links 17, 18. Then the actuating force is transmitted to the first rod part 8 via the active backdrop and the compression spring 6.
  • the link parts 14 to 20 are spring-biased in the proximal direction by the compression springs 6 and 7. It goes without saying that the number of components for the gradual closing force setting - such as compression springs, drivers and links - depends on the number of the closing force stages provided. In the example shown here, three stages are provided.
  • Figure 3 shows a position in which the maximum closing force is set. This is caused by the distal side Driver 11 is releasably fixed in the link 14, 15 and 16 and thus the force exerted on the proximally extending second and third rod parts 9, 10 is transmitted directly via the link parts 14, 15 to the first rod part 8, while the middle 12 and the proximal driver 13 can freely pass through the associated middle 17, 18 and proximal link 19, 20.
  • FIG. 4 again illustrates the setting position described above.
  • the distal driver 11 engages the web 21 between the two oval recesses 22 located in the link parts 15 and 16, so that the force transmission when the second and third rod parts 9, 10 are axially displaced onto the first rod part 8 can be done both in the distal and in the proximal direction.
  • the recesses 22 serve for a free axial passage of the inactive drivers. In this case, it is drivers 12 and 13.
  • the compression springs 6, 7 bring the link parts 18, 20 against annular shoulders 24 and 25 to the plant, in such a way that the annular shoulders 24, 25 secure the idle parts against proximal movement.
  • the annular shoulders 24, 25 are arranged in the device in such a way that they are permanently attached to a cylinder sleeve 27 arranged coaxially in the outer shaft 26. These, in turn, are fixed with their proximal end in the housing part 28, which is connected, for example, via a screw connection to the proximal housing part 29, on the proximal end of which handles 30 are fixed so as to be pivotable.
  • brackets 31 for the movement transmission, which adjust the actuating rod 3 when the two handles 30 are pressed together so that the Handle 4 transmits the force starting from the handles 30 via the bracket 31 to the proximal rod part 10, so that the rod parts 8, 9 and 10 are finally axially displaced distally. Otherwise, the brackets 31 automatically return the handle 4 and the actuating rod 3 to the starting position after releasing the locking means 5.
  • a hollow cylindrical switching ring 32 is provided on the proximal-side rod part 10, by means of which the rod part 9 can be rotated.
  • the switching ring 32 has an annular spring 34 which can be rotated relative to the fixed part 39. This engages with an inwardly directed nose 35 depending on the closing force to be set in one of the provided recesses 36, 37 or 38 of the fixed part 39.
  • This construction allows different settings to be made in a targeted and reliable manner, since the respectively set position of the rod part 9 can be felt by latching the nose 35 into one of the recesses 36, 37, 38.
  • Figure 4 and Figure 5 show the interaction of the individual components. If the rod part 9 is rotated by means of the switching ring 32 via the cylinder sleeve 41 until the ring spring 34 is led out of the recess 36 with its nose 35 and engages in the recess 37 with further rotation, the middle driver 12 is located with the corresponding Baffles 17 and 18 in engagement, while both the distal 11 and the proximal driver 13 with the associated baffles 14, 15, 16 and 19, 20 are out of engagement. In this position, the closing force is determined by the compression spring 6. In this second setting, the closing force is lower.
  • the transmission of the rotary movement of the switching ring 32 to the rotatable rod part 9, 10 takes place via the cylinder sleeve 41, which at its ends is inseparably connected to the parts 9 and 32 and is connected to the cylinder sleeve 42.
  • the cylinder sleeve 45 connected to the rod part 10 lies against the distal end of the cylinder sleeve 42.
  • 3 projections 11a, 12a and 13a are provided on the actuating rod according to FIG Corresponding distance is assigned on the proximal side and, when the actuating rod is adjusted distally, comes into rotational engagement with the recess 22 assigned to it.
  • the drivers 12, 13 protrude from the link parts 17, 18, 19, 20 by axially displacing the actuating rod 3, the projections 12a, 13a enter the associated recess 20, thereby securing the actuating rod against rotation.
  • the link parts 14, 17 and 19 should expediently be secured against radial rotation, for example by a pin engaging in an axially extending groove.
  • the scenery parts 14, 15, 16 and 17, 18 and 19, 20 should be fixed inseparably to one another in order to ensure that the complementarily designed recesses 22 always assume the same position relative to one another, that is to say cannot be rotated relative to one another during operation. Otherwise there would not be the possibility that the projections that are not in engagement with a link can freely pass through the link parts that are out of engagement.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Mechanical Engineering (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Medical Informatics (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Ophthalmology & Optometry (AREA)
  • Surgical Instruments (AREA)

Claims (11)

  1. Pince comportant deux éléments de mâchoire (1,2) servant à saisir et tenir un tissu ou analogue, dans laquelle au moins un élément de mâchoire (1) peut pivoter par rapport à l'autre (2) par déplacement d'une tige d'actionnement (3) à l'aide d'une poignée (4) et la position fermée des éléments de mâchoire (1,2) et de la poignée (4) peut être fixée par un dispositif d'arrêt (5), caractérisée en ce que la force de serrage des éléments de mâchoire (1,2) de la pince est réglable sur différentes valeurs, la force exercée par l'intermédiaire de la poignée (4) sur la tige d'actionnement (3) étant transmise à l'élément de mâchoire mobile (1) directement, dans le cas du réglage de la force de serrage maximale, et indirectement, dans le cas du réglage d'une autre force de serrage, plus faible, par l'intermédiaire d'au moins un ressort (6,7).
  2. Pince selon la revendication 1, caractérisée en ce que la tige d'actionnement (3) est constituée par un premier élément distal (8) et par des second et troisième éléments (9,10), qui s'étendent vers le côté proximal à partir du premier élément de la tige, en ce que le premier élément (8) de la tige est relié directement à l'élément de mâchoire mobile (1) et le troisième élément (10) de la tige est relié à la poignée (4) par l'intermédiaire de ressorts en forme d'étrier (31), en ce que le second élément (9) de la tige peut tourner par rapport au premier (8) en vue du réglage des paliers de la force de serrage et comporte des organes d'entraînement (11,12,13), qui sont disposés à distance l'un de l'autre en direction axiale et sont décalés angulairement les uns par rapport aux autres, et qui coopèrent avec des coulisses déplaçables axialement (14,15,16; 17,18; 19,20), de telle sorte que, dans une position angulaire prédéterminée du second élément (9,10) de la tige , un seul organe d'entraînement (11) est en prise avec une première coulisse (14,15,16) reliée de façon fixe au premier élément (8) de la tige, tandis que, dans une autre position angulaire prédéterminée, un autre organe d'entraînement (12 ou 13) vient en prise avec la coulisse (17, 18 ou 19, 20) associée à ce dernier, et transmet la force d'actionnement au premier élément (8) de la tige par l'intermédiaire de cette coulisse et d'au moins un ressort de compression (6,7).
  3. Pince selon la revendication 2, caractérisée en ce que le nombre des organes d'entraînement (11,12,13) et des coulisses (14,15,16; 17,18; 19,20), qui leur sont associées, correspond au nombre des paliers prévus de la force de serrage et en ce qu'entre des coulisses respectivement voisines (14,15,16, et 17, 18; 17,18 et 19,20), est inséré chaque fois un ressort de compression (6,7), au moyen duquel les coulisses sont reliées sans venir en butée de telle sorte que, dans le cas de la force de serrage la plus faible possible et dans le cas de la prédétermination de plus de deux paliers de la force de serrage, tous les ressorts sont montés en série.
  4. Pince selon l'une des revendications 2 et 3, caractérisée en ce que, dans les coulisses (14,15,16; 17,18; 19,20), sont prévus des évidements (22) permettant le passage axial libre d'organes d'entraînement (11,12,13) non situés dans la position de commutation.
  5. Pince selon l'une des revendications 2 à 4, caractérisée en ce que les ressorts de compression (6,7) appliquent des éléments de coulisse (17,19) contre des épaulements annulaires (24,25), de telle sorte que les épaulements annulaires (24,25) bloquent des coulisses situées en position de repos, contre tout déplacement vers le côté proximal.
  6. Pince selon l'une des revendications 2 à 5, caractérisée en ce que la tige d'actionnement (3) comporte, côté proximal, une bague de commutation (32) avec un ressort annulaire (34), qui peut tourner par rapport à un élément fixe (39) et qui s'engage par un bec (35), en fonction de la force de serrage devant être réglée, dans un évidement d'un ensemble de plusieurs évidements (36,37,38) de l'élément fixe (39).
  7. Pince selon la revendication 6, caractérisée en ce que le ressort annulaire (34) est bloqué en rotation sur la bague de commutation (32), par une goupille (40).
  8. Pince selon l'une des revendications 2 à 7, caractérisée en ce que le mouvement de rotation de la bague de commutation (32) sur le second élément rotatif (9,10) de la tige s'effectue par l'intermédiaire d'une douille cylindrique (41).
  9. Pince selon l'une des revendications 2 à 8, caractérisée en ce que les éléments (8,9,10) de la tige d'actionnement sont reliés, avec une possibilité de déplacement axial, par une tige (43), et sont bloqués contre un déplacement radial.
  10. Pince selon l'une des revendications 1 à 9, caractérisée en ce que la tige d'actionnement (3), qui est déplacée à partir de la position de repos vers le côté distal, est bloquée en rotation.
  11. Pince selon la revendication 10, caractérisée en ce que sur la tige d'actionnement (3), sont prévues des saillies (11a, 12a, 13a), dont chacune est associée à un organe d'entraînement respectif (11,12,13) et peut, dans le cas d'un déplacement vers le côté distal de la tige d'actionnement, être amenée en prise, selon une liaison d'entraînement en rotation, dans l'un des évidements (22).
EP93104077A 1992-05-22 1993-03-12 Pince pour la préhension et le maintien de tissus Expired - Lifetime EP0570675B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE4216971 1992-05-22
DE4216971A DE4216971C2 (de) 1992-05-22 1992-05-22 Zange zum Fassen und Halten von Gewebe oder dergleichen

Publications (2)

Publication Number Publication Date
EP0570675A1 EP0570675A1 (fr) 1993-11-24
EP0570675B1 true EP0570675B1 (fr) 1995-10-18

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EP93104077A Expired - Lifetime EP0570675B1 (fr) 1992-05-22 1993-03-12 Pince pour la préhension et le maintien de tissus

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Country Link
US (1) US5354313A (fr)
EP (1) EP0570675B1 (fr)
DE (2) DE4216971C2 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8915910B2 (en) 2008-03-31 2014-12-23 Applied Medical Resources Corporation Electrosurgical system
US9320563B2 (en) 2010-10-01 2016-04-26 Applied Medical Resources Corporation Electrosurgical instruments and connections thereto
US10149713B2 (en) 2014-05-16 2018-12-11 Applied Medical Resources Corporation Electrosurgical system
CN109331903A (zh) * 2018-11-23 2019-02-15 廖子宁 一种五金简单铸造用坩埚夹
US11540871B2 (en) 2014-12-23 2023-01-03 Applied Medical Resources Corporation Bipolar electrosurgical sealer and divider
US11696796B2 (en) 2018-11-16 2023-07-11 Applied Medical Resources Corporation Electrosurgical system
US11864812B2 (en) 2018-09-05 2024-01-09 Applied Medical Resources Corporation Electrosurgical generator control system

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DE4408475A1 (de) * 1994-03-14 1995-09-21 Wolf Gmbh Richard Chirurgische Zange
US5803649A (en) * 1995-11-14 1998-09-08 Hoogeboom; Thomas J. Locking mechanism
DE19707374C2 (de) * 1997-02-25 2000-10-26 Storz Karl Gmbh & Co Kg Medizinischer Dissektionsspatel mit spreizbaren Spatelmaulteilen
US6280458B1 (en) 1997-07-22 2001-08-28 Karl Storz Gmbh & Co. Kg Surgical grasping and holding forceps
DE19731454A1 (de) * 1997-07-22 1999-03-04 Storz Karl Gmbh & Co Chirurgische Faß- und Haltezange
DE19857323A1 (de) * 1998-12-11 2000-06-21 Aesculap Ag & Co Kg Chirurgisches Instrument
AU2007221906B1 (en) * 2007-10-09 2008-10-23 John Silady Control System for A Grasping Instrument
FR2948594B1 (fr) * 2009-07-31 2012-07-20 Dexterite Surgical Manipulateur ergonomique et semi-automatique et applications aux instruments pour chirurgie mini-invasive
JP5791053B2 (ja) 2009-10-09 2015-10-07 アプライド メディカル リソーシーズ コーポレイション 単孔式手術用器具
US20110190794A1 (en) * 2010-01-29 2011-08-04 Richard Wolf Gmbh Medical needle holder
GB2509110B (en) * 2012-12-20 2018-07-18 Gerard Michael Brooke Electrosurgical Forceps with Adjustable Spring
ES2682950T3 (es) 2014-05-30 2018-09-24 Applied Medical Resources Corporation Sistema electroquirúrgico con un instrumento que comprende una mandíbula con una almohadilla aislante central
US9561046B2 (en) 2014-10-24 2017-02-07 Gyrus Acmi, Inc. Instrument with resilient jaws
USD775332S1 (en) 2014-12-18 2016-12-27 Karl Storz Gmbh & Co. Kg Needle holder
USD748259S1 (en) 2014-12-29 2016-01-26 Applied Medical Resources Corporation Electrosurgical instrument
US10349963B2 (en) 2016-06-14 2019-07-16 Gyrus Acmi, Inc. Surgical apparatus with jaw force limiter
US11179190B2 (en) 2017-12-12 2021-11-23 Gyrus Acmi, Inc. Laparoscopic forceps assembly with an operable mechanism
US11350957B2 (en) 2019-03-27 2022-06-07 Gyms Acmi, Inc. Laparoscopic forceps assembly for gripping and dissection
WO2020205380A1 (fr) 2019-03-29 2020-10-08 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Pièce à main de pince pour accouplement d'arbre d'entraînement
KR20230167659A (ko) * 2022-06-02 2023-12-11 선지호 방향전환 기능이 있는 집게

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8915910B2 (en) 2008-03-31 2014-12-23 Applied Medical Resources Corporation Electrosurgical system
US9566108B2 (en) 2008-03-31 2017-02-14 Applied Medical Resources Corporation Electrosurgical system
US9320563B2 (en) 2010-10-01 2016-04-26 Applied Medical Resources Corporation Electrosurgical instruments and connections thereto
US10149713B2 (en) 2014-05-16 2018-12-11 Applied Medical Resources Corporation Electrosurgical system
US11672589B2 (en) 2014-05-16 2023-06-13 Applied Medical Resources Corporation Electrosurgical system
US11540871B2 (en) 2014-12-23 2023-01-03 Applied Medical Resources Corporation Bipolar electrosurgical sealer and divider
US11864812B2 (en) 2018-09-05 2024-01-09 Applied Medical Resources Corporation Electrosurgical generator control system
US11696796B2 (en) 2018-11-16 2023-07-11 Applied Medical Resources Corporation Electrosurgical system
CN109331903A (zh) * 2018-11-23 2019-02-15 廖子宁 一种五金简单铸造用坩埚夹

Also Published As

Publication number Publication date
EP0570675A1 (fr) 1993-11-24
DE4216971A1 (de) 1993-11-25
US5354313A (en) 1994-10-11
DE4216971C2 (de) 1995-06-08
DE59300771D1 (de) 1995-11-23

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